Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 May 26:8:e18.
doi: 10.1017/gmh.2021.15. eCollection 2021.

Effect of a lay counselor-delivered integrated maternal mental health and early childhood development group-based intervention in Northern Ghana: a cluster-randomized controlled trial

Joy Noel Baumgartner  1   2 , Mohammed Ali  3 , John A Gallis  2   4 , Margaret Lillie  2 , Raymond Owusu  3 , Safiyatu Abubakr-Bibilazu  3 , Haliq Adam  3 , Raymond Aborigo  5 , Elena McEwan  6 , Yunji Zhou  2   4 , Eunsoo Timothy Kim  2 , Jessica Mackness  2 , John Koku Awoonor Williams  7 , John Hembling  6
Affiliations

Effect of a lay counselor-delivered integrated maternal mental health and early childhood development group-based intervention in Northern Ghana: a cluster-randomized controlled trial

Joy Noel Baumgartner et al. Glob Ment Health (Camb). .

Abstract

Background: Caregiver mental health is linked to early childhood development, yet more robust evidence of community-based interventions to prevent maternal depression and optimize socio-emotional development of young children is needed. Objectives of this cluster-randomized controlled trial (cRCT), based in Northern Ghana, are to assess the impact of the lay counselor-delivered, group-based Integrated Mothers and Babies Course and Early Childhood Development (iMBC/ECD) program on (1) the mental health of mothers of children under age 2; and (2) the socio-emotional development of their children.

Methods: This cRCT randomized 32 women's groups - 16 received iMBC/ECD content (intervention) and 16 received general health education content (control). Surveys were administered at baseline, immediate post-intervention, and 8-month post-intervention. The primary outcome was maternal depression [Patient Health Questionnaire (PHQ-9)], and the secondary outcome was child's socio-emotional development [Ages and Stages Questionnaire: Social Emotional (ASQ:SE-2)]. Qualitative interviews with 33 stakeholders were also conducted.

Results: In total, 374 participants were enrolled at baseline while pregnant with the index child, 19% endorsing moderate/severe depression. Of these, 266 (71.1%) completed the 8-month post-intervention survey (~19 months post-baseline). There were no significant effects of iMBC/ECD on PHQ-9 and ASQ:SE-2 scores. However, results favored the intervention arm in most cases. iMBC participants were highly satisfied with the program but qualitative feedback from stakeholders indicated some implementation challenges.

Conclusions: This real-world evaluation had null findings; however, post-intervention depression levels were very low in both arms (3%). Future research should examine the potential impact of women's groups on postpartum mental health more broadly with varying content.

Keywords: Early childhood development; Ghana; infant mental health; maternal depression; socio-emotional health.

PubMed Disclaimer

Conflict of interest statement

JNB (senior author) reports a contract from Catholic Relief Services (CRS) during the conduct of the study; and six of the authors of this publication (JH, RO, MA, SA-B, HA, and EM) were paid employees of CRS, one of the funders, at the time this study was carried out and assisted with study design, data collection, and manuscript preparation. However, no CRS author had access to aggregate study data during data collection, nor was any CRS employee involved with data analysis.

Figures

Fig. 1.
Fig. 1.
CONSORT Diagram.
See this image and copyright information in PMC

References

    1. Aboud FE and Yousafzai AK (2015) Global health and development in early childhood. Annual Review of Psychology 66, 433–457. - PubMed
    1. Albanese AM, Russo GR and Geller PA (2019) The role of parental self-efficacy in parent and child well-being: a systematic review of associated outcomes. Child: Care, Health and Development 45, 333–363. - PubMed
    1. Austin MP, Frilingos M, Lumley J, Hadzi-Pavlovic D, Roncolato W, Acland S, Saint K, Segal N and Parker G (2008) Brief antenatal cognitive behaviour therapy group intervention for the prevention of postnatal depression and anxiety: a randomised controlled trial. Journal of Affective Disorders 105, 35–44. - PubMed
    1. Ballard T, Coates J, Swindale A and Deitchler M (2011) Household Hunger Scale: Indicator Definition and Measurement Guide. Washington, DC: Food and Nutrition Technical Assistance II Project, FHI 360.
    1. Bolzern JE, Mitchell A and Torgerson DJ (2019) Baseline testing in cluster randomised controlled trials: should this be done? BMC Medical Research Methodology 19, 106. - PMC - PubMed

LinkOut - more resources